56052_TOWN OF BEAUFORT_20100720

❑iCTM;% 1 ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue'
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
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Applicant Name k . -,, - l_.k-i, � Project Locatior
Address Street Address/
City State ZIP
Phone # O ;'' Fax # (,)
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AK(s): ElOEA [IHHF ElIH [IUBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
PZ,rf
Finge
Groi
Bulkl
Basir
Boat
Boat
Beac
Othc
Shor
SAV:
Sand
Mors
Phot
Wain
Subdivision
'71 �7' 010 �
Previous permit #
Date previous permit issued
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body `(nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: ,1 -1 L )
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A building permit may be required by: U See note on back regarding River Basin rules.
Notes/ Special Conditions
Agenf,or AppIcant Printed Name
Signature Pleaspread compliance statement on back of permit
Application Fee(s) Check #
The time period requirement for this
development is suspended until 12-31-
2010, pursuant to Senate Bill 831. The
PermitOffscer's Signature effective date of expiration for this
�-' j I (_. k permit is 1--/1
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name
-- - — - w'

r�
Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888ARCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

Applicaiit�6jjn
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your habitat code sheet.
Habitat Name
DISTURB TYPE.
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
tem_p impacts) -impact
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT RECEIVED .
(FOR A PIER/MOORING PILINGS/BOATLIFTB0 4TH 0USE)
I hereby certify that I own property adjacent to PO's
(N me of Property Owner) reheagcity DCM
property located at
S
(Lot, Block, Road,' etc.)
ont-ee- k , in C V e N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 2-Q ?Z-S 16 Mailing Address: L0 Y iG
1
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
_,x_ I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Te, "ve- )- c - 6t-1 2J p J r, r a � , J
(x r Jr— a We- 7DP T )--) ,�ii� �.
(Information for Property Owner Applying
for Permit)
✓oLt%,4�2 07 �Gl
Mailing Address
City/State/Zip
4?sZ7Z8"2166
Tel hone Number
1 0 VA,� � k2
Signature Date
(Riparian Property Owner Information)
// R
6 Signature
,L� RR Y -111NES
Print or Type Name
Zs2 72S �y� 9
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENTMP RECEIVED
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to Graden Paul Park
Diu
(Name of Property Owner) sIA90rehe0dC1ty0CM
property located at 7305 - 05 - 29 - 3303000
(Lot, Block, Road, etc.)
on Atlantic Ocean ,in Beaufort/Carteret N.C.
(Waterbody) (Town and/or County)
Applicant's phone #:
[phone] Mailing Address: NC State University, Box 7230
Raleigh, INC 27695
He has described to me, as shown below, the development he is proposing at that location, and, 1
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement. ^-IIA-------------------------------------------------------------------------------
-
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
6� (To befilled in by individual proposing development)
Il. � "pe— aill)- C • 6u , Gd p) iG Y' A f 6r4,�, Yl Pa
//✓ ,\�
�a r 1c
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-------------------------------------------------------------------------------------------------------------
(Information for Property Owner Applying
for Permit) /1
av Lei t,2 07
S'7r-ii'c ef
Mailing Address
City/State/Zip
ZS L 7Z8'
Tel hone Number
-.v
Signature Date
(RipariaA Property Owner Information)
Uatyiryh S Hart, T easurer Signature
North Car lina State University Foundation, Tnc.
Kathryn S. Hart
[phone]
Print or Type Name
Telephone Number
Date

L- X
c

Tseaufort
P.O. BOX 390
4
17 22 BEAUFORT, NORTH CAROLINA 28516-0390
�© [phone]
"1� Jed'
PAY ****200 DOLLARS AND 00 CENTS ****
PAY NCDENR - DIV OF COASTAL MGMT
TO THE
ORDER 400 COMMERCE AVENUE
OF MOREHEAD CITY, NC 28557
FIRST CITIZENS BANK 8 TRUST COMPANY 66-030 No. 0 2 81 i 3
Beauto,t t4 C 28516 531
DATE CHECK NO. CHECK AMOUNT
07/20/2010 28113 $200.00
VOID AFTER 90 DAYS
THIS DISBURSEMENT HAS BEEN APPROVED AS REQUIRED BY
THE LOCAL GOVERNMENT BUDGET and FISCAL CONTROL ACT.
W
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